ATTEMPTS TO PROLONG AND INTENSIFY SPINAL ANESTHESIA BY THE ADDITION OP EPHEDRINE, NEOSYNEPHRIN OR EPINEPHRINE TO A PONTOCAINE—GLUCOSE SOLUTION
Open Access
- 1 May 1949
- journal article
- research article
- Published by Wolters Kluwer Health in Anesthesiology
- Vol. 10 (3) , 260-269
- https://doi.org/10.1097/00000542-194905000-00002
Abstract
A standard dose of 10 mg. of pontocaine HC1 diluted to 3 cc. was administered to 539 patients. Of the 3 cc, 1 cc. was a 1% watery soln. of pontocaine HC1 and 1 cc. was 10% dextrose in all cases. In 105 patients used as controls, 1 cc. of spinal fluid; in 218 patients, 1 cc. of 5% ephedrine sulfate; in 106 patients, 0.5 cc. 0.2% neosynephrine and 0.5 cc. spinal fluid; and in 110 patients, 0.5 cc. 0.1% epinephrine and 0.5 cc. spinal fluid was added to the pontocaine-dextrose mixture. The patients underwent a wide variety of surgical procedures. They ranged in age from 13 to 88 yrs., in wt. from 97 to 270 lbs., and in height from 60 to 74 in. The addition of 50 mg. of ephedrine did not increase the duration of the motor block to any significant degree except in operations involving the lower extremities and the perineum where a 31% prolongation was noted. The addition of epinephrine and neosynephrine increased the duration of the motor block of the lower extremities from 32 to 66%, both drugs being about equally effective. The addition of ephedrine to the pontocaine-glucose mixture did not increase the duration of the sensory block. Neosynephrine and epinephrine increased the duration of the sensory block from 11 to 47%. The difference between the latter 2 drugs was not statistically significant. The authors give figures showing that the addition of any of the 3 vasopressor drugs did not increase the incidence of nausea, retching, or vomiting during operation. Following the addition of neosynephrine, or epinephrine, a drop of 25% or more was observed in the blood pressure of 43% and 40% of the cases, respectively. Of the control group, 26% of the cases had a decrease in blood pressure of 25% or more. None of the vasopressor drugs increased the incidence of the usual postoperative complications of spinal anesthesia.This publication has 1 reference indexed in Scilit: